| Objective:By choosing 52 patients with non small cell lung cancer (NSCLC)who were treated with three-dimensional conformal radiotherapy (3D-CRT), observing the changes of their pulmonary function before and after the radiotherapy. The effect of 3D-CRT in the low dose region V5 volume size on pulmonary function of patients with NSCLC was discussed.Methods:Collecting clinical data of 52 patients with NSCLC in 1,3,6 months before and after the radiotherapy who first underwent radical surgery and the successful completion of three-dimensional conformal radiotherapy in our hospital oncology Department from 2014 April to 2015 October. They were divided into the following three groups in accordance with different size in the dose volume histogram:V5≦45%,45%<V5≦55%,55%<V5<65%, set to A, B, C three groups, respectively with 20 cases,17 cases and 15 cases. The pulmonary function changes of the patients in three groups 1,3,6 months before and after radiotherapy were observed.Result:1.The forced Expiratory volume in the first second of expiration (FEV1%) and the forced vital capacity(FVC%) of all patients in 1 month after radiotherapy were significantly increased compared with those before radiotherapy. And the difference was significant(P<0.05). The FEV1% and FVC% in 3 and 6 months after radiotherapy were decreased gradually compared with radiotherapy after 1 month. The Diffusing Capacity for Carbon Monoxide (DLCO%) of all patients after radiotherapy was decreased compared with that before radiotherapy.2.The mean values of FEV1% and FVC% before radiotherapy in 39 cases of peripheral lung cancer patients were significantly higher than those in 13 cases of central lung cancer patients. And the difference was significant (P<0.05). The FEV1% and FVC% of patients in two clinical types of groups in 1 mouth after radiotherapy were higher than those before radiotherapy. And the difference was significant (P<0.05). The FEV1% and FVC% of patients 3 and 6 mouths after radiotherapy was lower than that of 1 mouth after radiotherapy. The DLCO% of patients in two clinical groups after radiotherapy showed a gradual downward trend compared with that before radiotherapy.3.The FEV1% and FVC% of patients of group A,B,C in two clinical types in 1 mouth after radiotherapy were higher than those before radiotherapy.And the difference of patients of group C in the two clinical types of was significant (P<0.05). The FEV1% and FVC% of patients of A,B,C group in two clinical types 3 and 6 mouths after radiotherapy showed a different trend of decline than that before radiotherapy, and that of C group in the two clinical types showed the most significant decline.4.The DLCO% of patients of A,B,C group in two clinical types 1,3 and 6 mouths after radiotherapy showed a different trend of decline than that before radiotherapy, and that of C group in the two clinical types showed the most significant decline.5. For the incidence of 0-1 level acute radiation lung injury, the value in group A(85.00%), was higher than those in group B(58.82%) and group C(40.00%). And the difference was significant (P<0.05). For the incidence of 2 level acute radiation lung injury, the value in group A(10.00%), was lower than those in group B(29.41%) and group C(33.33%). And the difference was significant (P<0.05).For the incidence of 3-4 level acute radiation lung injury, the values in group A(5.00%) and group B(11.77%), was lower than that in group C(26.67%). And the difference was significant (P<0.05). There was no incidence of 5 level acute radiation lung injury occurred in three groups.Conclusion:For patients with NSCLC who were treated by 3D-CRT, the influence of different V5 volume in radiotherapy treatment planning in pulmonary function changes after radiotherapy was different, and when the volume of low dose region in 55%<V5<65% was more significant compared with region of V5= 45% and 45<V5= 55% in the effects on lung function, especially on pulmonary diffusion function damage. With the increase of the volume of V5, the incidence rates of serious acute radiation lung injury had a trend of gradually increase. |
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